 Despite safety warnings not to give sick toddlers cough and cold medications, almost half of parents in a recent survey are using the over-the-counter products anyway. 尽管专家警告称给幼儿服用止咳和感冒药不安全，但近期一项调查显示，仍有近半数的美国家长在使用这些非处方产品。 A poll released last month by researchers at the University of Michigan found that 42% of parents with children under the age of 4 gave them cough medicine, and 44% said they used multi-symptom cough and cold medications. A quarter of the parents said they used decongestants. The survey, which echoed some earlier studies' findings, arrives five years after the drugs' packages started including directions warning against their use in very young children. 密歇根大学(University of Michigan)的研究人员上月发布的一项调查结果显示，42%的家长给四岁以下的孩子服用止咳药，44%的家长称，他们使用止咳和抗感冒的多疗效药，四分之一的家长称他们使用解充血药。此项调查（与早些时候一些研究的结果一致）是在这类药品的包装上开始标注低龄儿童慎用说明的五年之后展开的。 Matthew Davis, a University of Michigan pediatrician who directed the survey, said he was surprised and concerned by the findings, which may show that parents aren't aware of the labeling and the history of worries about the drugs' use in young children. 'If you're a parent who doesn't know the story, you're going to think this [medicine] is for your kids,' he says. 主持此项调查的密歇根大学儿科医生戴维斯(Matthew Davis)说，他对调查结果感到惊讶和忧虑。这一结果可能显示出，家长并不了解药品标签信息以及以往幼儿用药中出现的问题。他说：“作为家长，如果你不了解情况，你就会认为这种（药物）适合给你的孩子用。” The medications came under close scrutiny in 2008, when the Food and Drug Administration advised that they shouldn't be given to children under 2. That came after an agency advisory committee the previous year said children younger than 6 shouldn't take the medications. The panel concluded there wasn't evidence that the drugs helped young children, while FDA safety officials had suggested some of the drugs were associated with side effects and some deaths, mostly in very young patients and often involving overdoses. 这些药品2008年开始受到严格审视，当时美国食品和药物管理局(Food and Drug Administration, 简称FDA)建议，两岁以下儿童不应该服用这些药物。在此之前一年，该机构一个顾问委员会称，六岁以下儿童不应该服用这些药物。该委员会认为，没有证据显示这些药对幼儿有效，而FDA药品安全官员曾表示，其中一些药物可能有副作用，并与部分死亡事故存在关联，这些情况主要发生在年纪很小的患者身上，而且通常是过量服用。 Manufacturers agreed to put warnings on the products' boxes that they shouldn't be given to children under 4 years old. These appear today on medications that include dextromethorphan, a cough suppressant, the expectorant guaifenesin and the decongestants phenylephrine and pseudoephedrine. Medications with antihistamines warn against use in kids younger than 6. The children's cough and cold products are sold under brand names including Novartis AG's Triaminic and Pfizer Inc.'s Dimetapp and Robitussin. 制药公司同意在药品包装盒上标注四岁以下儿童禁用的警告。如今，镇咳药右美沙芬、祛痰药愈创甘油醚以及解充血药苯福林和伪麻黄硷的包装盒上就标注了警告。含有抗组织胺的药物对六岁以下儿童禁用。针对儿童的止咳和感冒药包括诺华制药公司(Novartis AG)的Triaminic以及辉瑞制药有限公司(Pfizer Inc.)的Dimetapp和Robitussi。 The Consumer Healthcare Products Association, which represents makers of the over-the-counter medications, says research it sponsors shows the rate of safety issues with the drugs has been dropping. Most cases involve children taking them without parental supervision, it says. The 'drug facts' summary panel, often found on the back of a medication box, which includes dosing and other information, is the best place for the age warnings, rather than breaking them out on the front of the package, said David Spangler, a senior vice president with the association. 代表非处方药生产商的美国消费者保健用品协会(Consumer Healthcare Products Association)称，该协会赞助的研究显示，这些药品安全问题的发生率已经有所下降。该行业协会称，多数问题都与儿童在无父母监督时服药有关。该协会高级副总裁斯潘格勒(David Spangler)表示，年龄警告最好写在“药品说明”总结栏内（通常在药盒背面，其中有剂量和其他信息），而不要单独写在包装盒正面。 The association has sponsored a campaign to alert parents on how best to use the medications, including public-service announcements, social-media efforts and brochures for family physicians to distribute to parents. Representatives of the industry group also said it can be challenging to design, and enroll participants for, studies testing medicines for children's colds. 该协会赞助了一项通过公益广告、社交媒体和发放宣传册（让家庭医生将宣传册发放给家长）等方式提醒家长如何更好地用药的活动。该协会代表还表示，检验儿童感冒药安全性的研究设计起来有难度，招募实验对象也有难度。 Pfizer said it 'encourages all parents to read and follow the label of any children's medication to determine appropriate use and dose.' A spokeswoman for Novartis said it declined to comment. 辉瑞公司称，该公司“鼓励所有家长阅读每一种儿童药品的标签，并遵照标签说明确定合适的用法和剂量”。诺华公司一名发言人称，该公司就此不予置评。 An FDA spokeswoman said the agency 'supports efforts. . .to better inform consumers about the safe and effective use of these products' and has worked with the Centers for Disease Control and Prevention on the issue. FDA一名发言人称，该机构“支持相关方面为此做出的努力……以使消费者更好地了解如何安全有效地使用这些产品”，并与美国疾病控制与预防中心(Centers for Disease Control and Prevention)就此进行了合作。Still, a study published in 2010 in the journal Child: Care, Health and Development, found that about a third of parents hadn't heard of the FDA recommendations, and of those who had, a third intended to keep using the medications. An earlier University of Michigan poll from 2011 found 61% of parents with children 2 and younger had given them cough and cold medications. 不过，学术期刊《儿童：护理、保健及发育》(Child: Care, Health and Development) 2010年刊登的一篇研究论文指出，有三分之一左右的家长未听说过FDA的建议，而在听说过FDA建议的家长中，又有三分之一的人想继续使用这些药品。密歇根大学2011年展开的一项调查发现，61%的家长曾给两岁及以下的孩子服用止咳和感冒药。 Another study, published recently in Clinical Pediatrics showed even higher numbers: 82% of 65 parents of children younger than 6 said they would use the medications, and nearly three-quarters of those indicated they would administer the wrong dose. 近期在《临床儿科学》(Clinical Pediatrics)上刊登的另一项研究结果所显示的比例更高：接受调查的65名六岁以下儿童家长中，有82%的人表示会使用这些药品，其中近四分之三的人表示，他们的给药剂量会有错误。 Some parents in that study would read the instruction not to give the medications to children younger than 4 and simply make up their own dose. They often extrapolated from doses recommended for older children, said Sarah G. Lazarus, a pediatrician at Children's Healthcare of Atlanta who was the lead author. She suggests the medications' age warnings, often found only in small print, may not be prominent enough on the packaging. 在该研究中，一些受访家长看过四岁以下儿童不宜服用的说明后会自行判断给药剂量。研究论文的第一作者、亚特兰大儿童医院(Children's Healthcare of Atlanta)的儿科医生拉扎勒斯(Sarah G. Lazarus)称，家长通常会根据针对年长一些的儿童的推荐剂量来进行推断。她指出，药品包装上的年龄警告（通常只用小字标注）可能不够醒目。 Doctors say they sometimes struggle to convince parents. 医生们表示，有时候他们很难说服家长。 'They're using them because their children are sick, and they want to do something,' says Daniel Frattarelli, who chairs the American Academy of Pediatrics' committee on drugs. He advises against the drugs. But if a mom hears from a friend who has used them and believes they work, he said he expects sometimes to be ignored. 美国儿科学会(American Academy of Pediatrics)药品委员会主席弗拉塔雷利(Daniel Frattarelli)称：“家长用这些药是因为他们的孩子病了，他们想做点什么。”他建议不要用药。但他说，如果一个妈妈听说有朋友用过这些药，并且相信这些药有效的话，他估计他的建议有时会被置之脑后。 Parents who avoid the over-the-counter medications are instead branching out with other treatments. Margaret Willis of Dearborn, Mich., whose 16-month-old daughter is a patient of Dr. Frattarelli's, says she is 'frustrated' that there aren't any medicines for her toddler's frequent colds and coughs. 不使用非处方药的家长会转向其他疗法。密歇根州迪尔伯恩(Dearborn)的威利斯(Margaret Willis)说，她女儿经常感冒咳嗽，却没有任何药可以用，让她颇为“失望”。她女儿16个月大，在弗拉塔雷利医生那儿看病。 'There's nothing out there for a baby,' she says. After trying a number of alternatives, Ms. Willis, a preschool teacher, finally settled on a treatment available on drugstore shelves that includes honey but no drugs, as well as a saline wash for the girl's nose. She believes the treatments helped somewhat, she says. 她说：“根本没有给婴儿用的药。”身为幼儿园老师的威利斯说，她尝试了许多替代方法，最终选定了一种在药店里卖的制剂，这种制剂含有蜂蜜，但不含药物成分，她还选择了一种洗鼻盐。她说，她觉得这些疗法有一定效果。 Doctors say they tell parents to try elevating their children's heads at night -- with babies, who aren't supposed to have objects in their cribs, parents can put towels under one end of the mattress or even use the car seat. Steam from a hot shower can also help, though some doctors warn that parents need to be careful with humidifiers, since they can develop mold. 医生们称，他们让家长试试夜间把孩子的头垫高──如果是婴儿的话（婴儿床里不应该放任何东西），家长可以在床垫的一头塞入毛巾，甚至可以使用汽车安全座椅。热水淋浴喷头的蒸汽也管用，但一些医生警告称，家长应该慎用加湿器，因为会产生霉菌。 Suctioning the nose is another option, as well as acetaminophen for fever, and another old standby: 'Lots of fluids,' says Alanna Levine, a pediatrician in Tappan, N.Y. For children older than 1 suffering from a cough, she also recommends a spoonful of honey, she says. Honey isn't recommended for babies because of the possibility it carries spores that could lead to botulism. One key goal in trying to soothe coughs is to help toddlers get adequate sleep, doctors said. 纽约州塔潘(Tappan)的儿科医生莱文(Alanna Levine)说，另一种选择方案是吸鼻涕，还可以用对乙口胺基酚来退烧，另外还有老话所说的“多喝水”。她说，一岁以上儿童咳嗽时，她建议可以喝一勺蜂蜜。但不建议婴儿喝蜂蜜，因为蜂蜜里可能会含有孢子，会导致肉毒杆菌中毒。医生说，镇咳的主要目的是帮助幼儿获得充足的睡眠。 Jennifer Chang, the mother of a 9-month-old and a 3-year-old who see Dr. Levine, has tried a honey-based preparation, as well as steamy showers and hydration. 住在纽约州奈阿克(Nyack)的Jennifer Chang有两个孩子，一个九个月大，一个三岁，他们在莱文医生那里看病。Jennifer Chang试过蜂蜜配方制剂，还试过淋浴蒸汽和让孩子多喝水。 'It seems like there's not a whole lot you can do,' says Ms. Chang, of Nyack, N.Y. 'I want to make it feel better.' Jennifer Chang说：“你似乎没有太多可做的。但我很想让孩子舒服一点。” | |
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